Lidocaine for Chronic Pain: Effectiveness, Safety, and Symptom Relief [Conference Winner Abstract]

Introduction Chronic pain impairs quality of life and productivity. Intravenous (i.v.) lidocaine, a commonly used anesthetic, has shown promise for chronic pain management. Recent studies highlight that i.v. lidocaine provides significant pain relief and improves chronic pain-related symptoms, particularly in neuropathic pain conditions [1]. Additionally, it has been shown to stabilize hemodynamic parameters, ensuring its safety during administration [2]. Further research is needed to comprehensively understand its impact on pain relief, hemodynamics, and symptom management. Aim To evaluate the effectiveness and safety of i.v. lidocaine in managing pain, addressing associated symptoms, and assessing its impact on hemodynamic parameters. Methods In total, 75 patients were analyzed retrospectively (44% male; mean age 49.6 years), receiving i.v. lidocaine (1 mg/kg) for chronic pain. Data on pain scores, symptom improvement, hemodynamic parameters, and the role of work type in the onset of pain were obtained from an anonymous questionnaire previously administered to patients during one of their 1st to 6th treatment sessions. Results Pain scores dropped significantly from 8.89 to 6.65, representing a 25.2% reduction (p < 0.001). The most common pain quality reported was stinging (53%, n = 40), followed by burning (21%, n = 16) and locking (12%, n = 9). Notably, lidocaine demonstrated better outcomes for upper-back and neck pain (40.5%, p < 0.01) compared to lower-back pain (19.2%, p < 0.01). Before treatment, 80% of patients (n = 60) reported problems with sleep, 68% (n = 51) experienced reduced activity, and 64% (n = 48) noted emotional suffering. Following treatment, significant improvements were observed, particularly in sleep quality (45%, n = 34, p < 0.01), emotional well-being (24%, n = 18, p < 0.01), and physical activity (15%, n = 11, p < 0.01). Among these, sleep quality showed the most pronounced improvement. In terms of hemodynamic effects, systolic blood pressure decreased by 8.4 mmHg (p = 0.053), diastolic blood pressure by 5.1 mmHg (p = 0.078), and heart rate by 3.6 bpm (p = 0.084). These changes remained within safe clinical limits. Side effects were minimal, with only 2.67% (n = 2) of patients experiencing mild dizziness, and no other adverse effects reported. Conclusions Intravenous lidocaine (1 mg/kg) significantly reduces pain and improves symptoms, with minimal side effects. It is particularly effective for upper back and neck pain, distinguishing it as a targeted option for chronic pain in these areas. The observed hemodynamic stability further supports its use as a safe therapy. Future research in larger, randomized studies is warranted to validate these findings and explore lidocaine’s therapeutic potential.